Chapter 6: Drug Formulations & Patient Counseling Flashcards
Which 5HT3-RA comes in a long-acting patch?
Granisetron
Which sweetener added to some drug formulations causes gas, cramping, and bloating in sensitive patients (i.e. patients with IBS)?
Sorbitol
Which sweetener is dangerous for those with phenylketonuria (PKU)?
Phenylalanine
What is the most commonly used excipient in drug formulations?
lactose
What should you instruct patients on when using granules, powders or capsules that can be opened and sprinkled into soft food and water?
- Do not chew any long-acting pellets or beads that are emptied out from a capsule
- Do not let the mixture sit too long if capsule contents are mixed in food or liquid
- Do not add to anything warm or hot
T or F: you can crush or chew long-acting medications
false; this could lead to a fatal dose
What are osmotic release oral systems?
They provide fast drug delivery
followed by an extended release in one drug
What is an important counseling point about osmotic release oral systems (OROS)?
The tablet/shell may be visible in the patient’s stool (called a ghost tablet/capsule)
Why are long-acting medications used?
- To avoid nausea or provide a long duration of action
- Reduces high “peaks” which reduces side effects
T or F: some long-acting opioid capsules can be opened and the contents sprinkled on certain foods
True
Which long-acting medications can be cut at the score line?
toprol XL
sinemet CR (carbodopa/levodopa)
Where on the body can patches be placed?
chest (upper)
back (upper and lower)
upper arm (on the part facing out)
flanks (sides of the body, abdomen level)
Where is Daytrana patch applied?
To the hip
alternating between right and left hip daily
Where is Transderm Scop patch applied?
Behind the ear
at least 4 hours before needed
alternating ears Q72H
Which patch can be cut into pieces?
Lidoderm
What happens if you apply heat to a patch?
Heat causes rapid absorption of the medication
Which patches can be covered with adhesive film if it does not stick?
fentanyl (Duragesic)
buprenorphine (Butrans)
only with the permitted adhesive film dressings, Bioclusive or Tegaderm
Catapres-TTS comes with its own adhesive cover
T or F: you can flush some highly potent narcotic patches down the toilet to remove it from the home immediately?
True - these include
Duragesic
Butrans
Daytrana
What are some counseling points for all monoclonal antibodies?
Do not shake the medication
avoid exposing the drug to extreme temperatures (hot or cold)
How many times should a gel eyedrop be shaken prior to use?
once
How long should you wait to use another medication in your eye after using an eye drop?
5-10 minutes
How long should you wait to use a gel in your eye after using an eye drop?
10 minutes
What should you do if your eye drop contains a preservative called benzalkonium chloride (BAK) and you wear soft contact lenses?
remove the lenses prior to administration
(wait 15 min to reinsert)
When using eardrops on an adult, how would you pull the ear when administering?
For a child?
adult: up and back
child: down and back if < 3 years
How long should you keep your ear facing up after administering an ear drop
5 minutes
When would an ODT be useful
Patients with
dysphagia (difficulty swallowing)
children
nausea
vomiting
non-adherence
Why would sublingual or buccal delivery with a tablet, film, powder or spray be useful
Has a faster onset of action & less drug is lost to gut deterioration & first-pass metabolism
Singulair granules can be mixed in 5 ml baby formula or breast milk or:
Spoonful of applesauce
carrots
rice
ice cream
Exelon patch is NOT applied to which part of the body that most patches can be placed
flanks (sides of body, abdomen level)
How is lidocaine patch applied
1-3 patches
on for 12 hours
then off for 12 hours (as needed)
How is nitroglycerin patch applied
On for 12-14 hrs
then off for 10-12 hrs
When applying an eye drop, how long should you press down between your eye and the top of your nose after applying a drop
one full minute
Patches that are applied daily
Daytrana patch - QAM, 2 hours prior to school
Nicotine (NicoDerm CQ) patch
Rivastigmine (Exelon) patch
Rotigotine patch
Selegiline patch
Testosterone patch - nightly (not on scrotum)
Which two patches are applied Q72H
Fentanyl
Scopolamine
Which patches are applied weekly
buprenorphine (Butrans)
clonidine
estradiol (Climara)
estradiol/levonorgestrel
Which patches are applied twice weekly
estradiol (Alora, Vivelle-Dot)
oxybutinin (Oxytrol)
Which patch is applied weekly for 3 weeks off for the 4th week
Ethinyl estradiol/Norelgestromin (Xulane)
Which patch is applied twice daily
Diclofenac - (remember, di=2)
